Individual
MRS. CAROLINE LIESELL MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
5347 S VALENTIA WAY, SUITE 120, GREENWOOD VILLAGE, CO 80111-3107
(720) 253-7985
Mailing address
9659 MOSS ROSE CIR, HIGHLANDS RANCH, CO 80129-6437
(720) 253-7985
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
STATE LICENSE PENDIN
CO
Other
Enumeration date
06/02/2013
Last updated
06/02/2013
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